NPIMap

Organization Active NPI

Air Evac EMS, Inc.

Doing business as Air Evac LIfeteam

  • Air Ambulance
  • Fort Smith, AR
National Provider Identifier
1679085989
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Air AmbulanceTaxonomy code 3416A0800X
Legal business name
AIR EVAC EMS, INC.
Doing business as
Air Evac LIfeteam
Practice address
1321 Dodson Ave
Fort Smith, AR 72901-5107
Phone
(877) 288-5340
Fax
(417) 257-5761
NPI assigned
Oct 26, 2017
Last updated
Feb 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
AIR EVAC EMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric Thomas
Title
SVP of Revenue Management
Phone
(877) 288-5340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Air Ambulance 3416A0800X Primary

Addresses

Primary practice location

1321 Dodson Ave
Fort Smith, AR 72901-5107

Mailing address

PO Box 106
West Plains, MO 65775-0106
Phone (877) 288-5340

Other names 1

  • Air Evac LIfeteam Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000228 AR Part B Supplier - Ambulance Service Supplier 8123931755 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: De Queen, AR; Springdale, AR; Mountain Home, AR; Harrison, AR; Forrest City, AR; Fort Smith, AR; Clarksville, AR; Blytheville, AR

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2143000Air Evac Lifeteam 1491321 Dodson Ave, Fort Smith, AR 72901Certificate of waiverJan 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Air Evac EMS162 organizations share this tax ID, including this one
Part of
Air Evac EMS

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1679085989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657750106",
            "telephone_number": "877-288-5340",
            "fax_number": "417-257-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 DODSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015107",
            "telephone_number": "877-288-5340",
            "fax_number": "417-257-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIR EVAC EMS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AIR EVAC EMS, INC.",
        "enumeration_date": "2017-10-26",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SVP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "877-288-5340"
    },
    "taxonomies": [
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Air Evac LIfeteam",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.